Maizie Marie Shaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089572 Issued in NY

Practice address

660 Madison Street
Syracuse, NY 13210

Phone

(315) 426-7680

Fax

(315) 426-7793

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1558973586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MADISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102338",
            "telephone_number": "315-426-3600",
            "fax_number": "315-426-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 MADISON STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-426-7680",
            "fax_number": "315-426-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MAIZIE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "maizie.shaw@omh.ny.gov",
            "affiliation": "Y",
            "affiliationName": "Hutchings Psychiatric Center",
            "address_1": "620 Madison St",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132102319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mishal Shaukat, MD
• Coleen Teri Shaver
• Andrea Vittoria Shaw, MD
• Eric Gorgon Shaw, M.D.
• James Albert Shaw, M.D.
• Mary Shaw, RN
• Melinda M Shaw, PA
• Michael Jonathan Shaw, MD
• Palma M Shaw, M.D.
• Susan F. Shaw, NP

• Clinical Social Worker in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.